Provider Demographics
NPI:1326566092
Name:PREMUS, JENNIFER MARY (BCO)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MARY
Last Name:PREMUS
Suffix:
Gender:F
Credentials:BCO
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Mailing Address - Street 1:2800 VETERANS MEMORIAL BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-522-2354
Mailing Address - Fax:504-596-6733
Practice Address - Street 1:2800 VETERANS MEMORIAL BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-522-2354
Practice Address - Fax:504-596-6733
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist